1346051737 NPI number — MRS. SHANNON ELIZABETH LANGFORD CSFA

Table of content: MRS. SHANNON ELIZABETH LANGFORD CSFA (NPI 1346051737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346051737 NPI number — MRS. SHANNON ELIZABETH LANGFORD CSFA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANGFORD
Provider First Name:
SHANNON
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CSFA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LANGFORD
Provider Other First Name:
SHANNON
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CSFA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1346051737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1586 SWEET PLUM CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32312-8087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-510-9652
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 RED BUD RD NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALHOUN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30701-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-602-7800
Provider Business Practice Location Address Fax Number:
706-624-5019
Provider Enumeration Date:
01/15/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246ZC0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)